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What Causes Breakthrough Bleeding While On Topomax?
Question: I have been taking Topomax 50mg a day (25 morning and 25 night) since January 20th, for weight loss. I've lost 50 lbs. Two months ago , my doctor put me on an ultra low dose birth control pill, for continuous birth control, to prevent pregnancy, as Im having a "date" in august, and because I have heavy periods. I understand that Topomax can decrease the effectiveness of the birth control pill. But that im not worried about as, I have other issues that make it harder for me to get pregnant so that is just another precaution. What im concerned with, is the fact that since starting to take the ultra low dose pill, 2 months now, I've had breakthrough bleeding , that's like a regular period, cramps, clots, etc. BOTH MONTHS. Now, I'm not sure if it's because I need a higher estrogen dose, because Im at the lowest dose possible, or if it's because of the Topomax. Im really NOT wanting to stop the Topomax, as it's the ONLY thing that's been able to help me lose weight in 20 years. But at the same time, I can't go on my "date" with breakthrough bleeding so bad that it's like a period either. Right now I have a call into my doctor to switch me up to a higher level estrogen pill, but Im not sure if 50 mg of Topomax would cause this to happen...and no one, not even doctors are able to tell me...
Brief Answer:
Topamax increases risk of breakthrough bleeding but not of pregnancy
Detailed Answer:
Hello, and I hope I can answer your question today.
Well it is true that certain kinds of birth control pills can be affected by the levels of certain kind of seizure medications, in your case, the class of seizure medicine that Topamax is in just may increase the side effect of breakthrough bleeding in doses of less than 150 mg without decreasing the effectiveness.
However, ultra low-dose birth control pills have an increased failure rate in patients who weigh over 180 pounds to begins with.
So in your case I agree that it would be prudent for you to switch to a different brand of birth control pill that contains a slightly higher dose of estrogen. That should reduce your symptoms of breakthrough bleeding, give you greater cycle control, and protect you more effectively against pregnancy.
I hope that I was able to adequately answer your question today, and that my advice was helpful. If you need anything further, please do not hesitate to contact me.
Best wishes,
Dr. Brown
Topamax increases risk of breakthrough bleeding but not of pregnancy
Detailed Answer:
Hello, and I hope I can answer your question today.
Well it is true that certain kinds of birth control pills can be affected by the levels of certain kind of seizure medications, in your case, the class of seizure medicine that Topamax is in just may increase the side effect of breakthrough bleeding in doses of less than 150 mg without decreasing the effectiveness.
However, ultra low-dose birth control pills have an increased failure rate in patients who weigh over 180 pounds to begins with.
So in your case I agree that it would be prudent for you to switch to a different brand of birth control pill that contains a slightly higher dose of estrogen. That should reduce your symptoms of breakthrough bleeding, give you greater cycle control, and protect you more effectively against pregnancy.
I hope that I was able to adequately answer your question today, and that my advice was helpful. If you need anything further, please do not hesitate to contact me.
Best wishes,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
so by going on a higher dose bc pill should eliminate the breakthrough bleeding and I wouldn't have to go off the topamax? or should i still drop the topamax?im not really concerned by the effectiveness of the bc pill, im more concerned whether the topamax will cause breakthru bleeding..
Brief Answer:
You do not need to stop the Topamax just try a new pill
Detailed Answer:
Hello again,
You do not need to stop the Topamax medication if you are having beneficial effects from it with losing weight however you may have more relief from breakthrough bleeding if you switch to a pill that contains more estrogen. However, breakthrough bleeding can be a problem at all new birth-control users. You may expect breakthrough bleeding even within the first three months of use regardless of which brand of pill that you try.
So again, breakthrough bleeding is a common problem in the first three months of use on any type of birth control. There is no need for you to discontinue Topamax if it otherwise is helping you. However, there is no guarantee that even with changing your pill that the problem breakthrough bleeding will be controlled. If you switch your birth control pill and still have a breakthrough bleeding problem after three months, then I would discontinue the Topamax.
I hope this additional information was helpful to you and if I could be of any further assistance again, do not hesitate to contact me.
Best wishes,
Dr. Brown
You do not need to stop the Topamax just try a new pill
Detailed Answer:
Hello again,
You do not need to stop the Topamax medication if you are having beneficial effects from it with losing weight however you may have more relief from breakthrough bleeding if you switch to a pill that contains more estrogen. However, breakthrough bleeding can be a problem at all new birth-control users. You may expect breakthrough bleeding even within the first three months of use regardless of which brand of pill that you try.
So again, breakthrough bleeding is a common problem in the first three months of use on any type of birth control. There is no need for you to discontinue Topamax if it otherwise is helping you. However, there is no guarantee that even with changing your pill that the problem breakthrough bleeding will be controlled. If you switch your birth control pill and still have a breakthrough bleeding problem after three months, then I would discontinue the Topamax.
I hope this additional information was helpful to you and if I could be of any further assistance again, do not hesitate to contact me.
Best wishes,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Yogesh D
so would a monophasic or a triphasic or what kind of pill be better....im curious because i leave to go to New Mexico for 10 days on August 19-29, and I want to make sure that im not bleeding in any form when Im down there.....It would ruin the whole time ....also, what are the statistics of women that experince breakthrough bleeding on the higher dosage as one of the side effects? I know it CAN be a side effect, but what are the chances? In the early 2000s I took Seasonale, and I don't recall ever having breakthrough bleeding. I know things are different now though. WHat is a good kind of pill combination that would cause the least chance for bleeding. That is my major worry, is that I will get down to New Mexico, and my one chance I have to be with this guy and I will start bleeding...
Brief Answer:
There is no way to know in advance what pill will work for your system
Detailed Answer:
So, unfortunately, there is no way to predict what brands of birth control will cause more or less breakthrough bleeding in someone without trying it and seeing what happens. In general, monophasic pills are a better choice than triphasic ones because the hormone dose is constant during the active pill cycle. About 10-20 percent of women experience breakthrough bleeding on birth control pills, especially in the first three months of use, and in general fewer women have this side effect with higher estrogen pills. But some women will breakthrough bleed on any pill they try, and some women never have breakthrough bleeding but have other side effects they find bothersome.
There is no "best" brand of birth control, and it takes trial and error to find the right formulation for each patient. Unfortunately, that is the most information any doctor will be able to give you in this situation. I cannot give you a percentage because no medical study had been done on patients who are in your exact situation and on the exact same combination of medicines.
The best way I have found to try to choose a birth control pill for my patients is by asking if they had a good experience in the past with any particular brand of pill and starting out with that. If you did not have breakthrough bleeding on Seasonale (granted- you may have been younger and/or not overweight at that time) I think it would be worth trying Seasonale again or another brand of pill containing Levonorgestrel (the active ingredient) with at least 30 micrograms of estrogen. There is no way to know if stopping the Topamax will change anything as you are on such a low dose.
So in summary, I think your greatest chance of getting the bleeding under control will be to start Seasonale again. You do not need to go off your current pill for a period of time before changing if you are early in your pack. If you are close to the pill-free week, then I would stop the old pill, wait 4-7 days, then start the Seasonale.
I hope this additional information was helpful and that the Seasonale kicks in by the time you will be taking your trip.
Thank you again for using my services and Healthcaremagic.com
Regards,
Dr. Brown
There is no way to know in advance what pill will work for your system
Detailed Answer:
So, unfortunately, there is no way to predict what brands of birth control will cause more or less breakthrough bleeding in someone without trying it and seeing what happens. In general, monophasic pills are a better choice than triphasic ones because the hormone dose is constant during the active pill cycle. About 10-20 percent of women experience breakthrough bleeding on birth control pills, especially in the first three months of use, and in general fewer women have this side effect with higher estrogen pills. But some women will breakthrough bleed on any pill they try, and some women never have breakthrough bleeding but have other side effects they find bothersome.
There is no "best" brand of birth control, and it takes trial and error to find the right formulation for each patient. Unfortunately, that is the most information any doctor will be able to give you in this situation. I cannot give you a percentage because no medical study had been done on patients who are in your exact situation and on the exact same combination of medicines.
The best way I have found to try to choose a birth control pill for my patients is by asking if they had a good experience in the past with any particular brand of pill and starting out with that. If you did not have breakthrough bleeding on Seasonale (granted- you may have been younger and/or not overweight at that time) I think it would be worth trying Seasonale again or another brand of pill containing Levonorgestrel (the active ingredient) with at least 30 micrograms of estrogen. There is no way to know if stopping the Topamax will change anything as you are on such a low dose.
So in summary, I think your greatest chance of getting the bleeding under control will be to start Seasonale again. You do not need to go off your current pill for a period of time before changing if you are early in your pack. If you are close to the pill-free week, then I would stop the old pill, wait 4-7 days, then start the Seasonale.
I hope this additional information was helpful and that the Seasonale kicks in by the time you will be taking your trip.
Thank you again for using my services and Healthcaremagic.com
Regards,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Yogesh D
ok if you take the XXXXXXX pill, i know there can be more breakthrough bleeding there, than on combination birth control pills is that correct?......also at what point during the cycle does most of the breakthrough bleeding occur?....midcycle is what im seeing.. im also reading that combination pills arent' good for women that are overweight? is that for effectiveness, or is that for side effects...I was on the minipill a while back because I had a heavy period we wanted to stop....but I was only on a few weeks, and I dn't remember if i had breakthrough bleeding or not.
Brief Answer:
You get better cycle control with an estrogen containing pill
Detailed Answer:
Hello again,
Regarding the mini-pill (Prograterone only) they are taken daily (no pill free week) so you do not get regular periods taking this pill, which is why many women who are breastfeeding do well with it because they do not menstruate. Women who menstruate usually get breakthrough bleeding as a side effect. So I would not recommend that kind of pill for you. The breakthrough bleeding is unpredictable.... some women spot before or after their period and some bleed midcycle.
Secondly, regarding birth control and obesity, it is true that there are more health risks associated with estrogen containing birth control pills because estrogen increases the risk of clotting. When combined with other risk factors that many obese women have, such as hypertension, diabetes, and other cardiac risk factors, the pill can increase cardiovascular risks. This is also why women who are over 35 years of age and smoke are not recommended to take estrogen. Furthermore, women over 180 pounds have a higher risk of getting pregnant.
If you are otherwise healthy, have no history of blood clots and do not smoke, a combination birth control pill is still your best option for cycle control and contraception. I think your breakthrough bleeding would get much worse if you took the mini-pill instead.
Hope that clarifies things.
Regards,
Dr. Brown
You get better cycle control with an estrogen containing pill
Detailed Answer:
Hello again,
Regarding the mini-pill (Prograterone only) they are taken daily (no pill free week) so you do not get regular periods taking this pill, which is why many women who are breastfeeding do well with it because they do not menstruate. Women who menstruate usually get breakthrough bleeding as a side effect. So I would not recommend that kind of pill for you. The breakthrough bleeding is unpredictable.... some women spot before or after their period and some bleed midcycle.
Secondly, regarding birth control and obesity, it is true that there are more health risks associated with estrogen containing birth control pills because estrogen increases the risk of clotting. When combined with other risk factors that many obese women have, such as hypertension, diabetes, and other cardiac risk factors, the pill can increase cardiovascular risks. This is also why women who are over 35 years of age and smoke are not recommended to take estrogen. Furthermore, women over 180 pounds have a higher risk of getting pregnant.
If you are otherwise healthy, have no history of blood clots and do not smoke, a combination birth control pill is still your best option for cycle control and contraception. I think your breakthrough bleeding would get much worse if you took the mini-pill instead.
Hope that clarifies things.
Regards,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Yogesh D
Ok, sorry to bother you again, i just want to make sure I get the correct answers instead of what im finding on the internet. I want to do continuous birth control..to which I do not get a period....is it better to do this with a monophasic .35mg birth control pill, or to do it with something like seasonique. Also...I know they discontinued Lybrel, but did they replace it with anything?
Brief Answer:
The reason Lybrel was discontinued is that 40% had breakthrough bleeding
Detailed Answer:
The reason why Lybrel was discontinued from the market was because it actually did not suppress the menstrual cycle for full year as it was advertised.
Up to 40% of patients had breakthrough bleeding, however the total number of bleeding days per year was still less than what women would experience with a cyclic menstrual cycle. Lybrel however turned out to be unpopular because of the side effects, and that was the reason it was discontinued. Lybrel actually had the same ingredients as Seasonale. No triphasic pill has been studied for extended cycle use.
The reason the three month cycle pills were designed that way was that studies show that most women could not completely suppress bleeding for more than three months at a time.
In my experience, it is best to start with a monthly cycle pill for 3 months and then switch to a 3-months at a time pill for a while, see how that works, and then see if you can extend your cycle further. Most women have breakthrough bleeding in the first 3 months on extended cycle pills when they first start.
There are no 35 microgram pills that have more than 21 active pills in a pack either, so you may have problems getting refills.
I think you should just try a 35 microgram, monophasic, monthly cycle pill and just take two packs back to back while you are on your trip (if you are due for your period then). Then later, cycling every 3 months would give you the fewest days of bleeding with a lower chance of breakthrough bleeding in between. Any monophasic pill that has 30-35 micrograms of estrogen should be effective. Later, try taking the pills continuously for as long as you can, and just stop them for a week if you begin to bleed. Many women can get up to 6 months between cycles, with gradual increases.
I hope this regimen works for you and that my advice has been helpful.
Sincerely,
Dr. Brown
The reason Lybrel was discontinued is that 40% had breakthrough bleeding
Detailed Answer:
The reason why Lybrel was discontinued from the market was because it actually did not suppress the menstrual cycle for full year as it was advertised.
Up to 40% of patients had breakthrough bleeding, however the total number of bleeding days per year was still less than what women would experience with a cyclic menstrual cycle. Lybrel however turned out to be unpopular because of the side effects, and that was the reason it was discontinued. Lybrel actually had the same ingredients as Seasonale. No triphasic pill has been studied for extended cycle use.
The reason the three month cycle pills were designed that way was that studies show that most women could not completely suppress bleeding for more than three months at a time.
In my experience, it is best to start with a monthly cycle pill for 3 months and then switch to a 3-months at a time pill for a while, see how that works, and then see if you can extend your cycle further. Most women have breakthrough bleeding in the first 3 months on extended cycle pills when they first start.
There are no 35 microgram pills that have more than 21 active pills in a pack either, so you may have problems getting refills.
I think you should just try a 35 microgram, monophasic, monthly cycle pill and just take two packs back to back while you are on your trip (if you are due for your period then). Then later, cycling every 3 months would give you the fewest days of bleeding with a lower chance of breakthrough bleeding in between. Any monophasic pill that has 30-35 micrograms of estrogen should be effective. Later, try taking the pills continuously for as long as you can, and just stop them for a week if you begin to bleed. Many women can get up to 6 months between cycles, with gradual increases.
I hope this regimen works for you and that my advice has been helpful.
Sincerely,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
the only time im really concerned about NOT having a period or breakthrough bleeding is when Im on my trip with him :) ....If im currently taking the orsythia, and I just start taking the upped dosage, and more hormones usually = less breakthrough bleeding, then I should be fine as far as that goes....Im looking into Ortho-Novum 1/35...I've been reading tons of reviews by women and they talk about a lot of side effects but none of them are bleeding. Also.....if the breakthrough bleeding IS caused by the topomax, if I took the ortho-novum 1/50 would that lower the chances of the breakthrough bleeding even more....
As you can see, I just don't want to be bleeding in any way shape or form when im with him the 19th-29th of August,.. :)Originally I had actually asked this question to 2 different gynocologists, not sure who would answer first. The answer I got from the other one was this:
Since I am only concerned about bleeding from the 19th -29th of august.....which is what the main issue is for me....That I should continue with my current low dose birth control pill...then a few days before I leave start taking Norethisterone 5 mg, also and take it like that for the entirety of my trip and then stop when i return home and I shouldnt have any problems with breakthrough bleeding while I'm with him the 19th-29th....Is this accurate? I have heard something like this before. I would much rather do something like this than start a whole new pill if this is will work. She said it works very well.....
As you can see, I just don't want to be bleeding in any way shape or form when im with him the 19th-29th of August,.. :)Originally I had actually asked this question to 2 different gynocologists, not sure who would answer first. The answer I got from the other one was this:
Since I am only concerned about bleeding from the 19th -29th of august.....which is what the main issue is for me....That I should continue with my current low dose birth control pill...then a few days before I leave start taking Norethisterone 5 mg, also and take it like that for the entirety of my trip and then stop when i return home and I shouldnt have any problems with breakthrough bleeding while I'm with him the 19th-29th....Is this accurate? I have heard something like this before. I would much rather do something like this than start a whole new pill if this is will work. She said it works very well.....
Brief Answer:
I do not agree with taking extra progesterone to prevent breakthrough bleed
Detailed Answer:
Norethisterone is simply a synthetic form of the hormone progesterone, in a tablet. There are 35 µg pills such as Necon 1/35 that contain 35 µg of estrogen and the US equivalent of Norethisterone. This pill is also well tolerated by patients and would be a good choice for continuous cycling.
Progesterone, like norethisterone, when given to a normally menstruating woman who is not on birth control, will delay your cycle because progesterone is the hormone primarily responsible for stabilizing the uterine lining after ovulation. For this purpose, it works very well. But if you are on birth control, adding extra progesterone will not necessarily help prevent breakthrough bleeding. This makes sense if you understand that in a normal menstrual cycle, when you're not on the pill, your estrogen levels are much higher than when taking a low dose birth control pill. So then progesterone alone would stabilize your uterine lining that is been built up by all the estrogen of your normal cycle.
I would NOT recommend a 50 µg birth control pill because these are considered high-dose formulations and in reality no form of birth-control above 35 mg provides any additional help with breakthrough bleeding over the modern low (35 microgram) dose formulations. Furthermore, because of your obesity, I would not recommend taking this high dose of estrogen because of the risk of blood clotting.
As I stated previously I would recommend either changing back to Seasonale, which works for you before, or starting a monthly cycle pill such as Necon 1/35 which contains the US equivalent of norethisterone. Your body has about six weeks to adjust to a new pill formulation before your holiday. I do not recommend staying on your current pill as you already have breakthrough bleeding while taking it. It makes more sense to start on a new pill and try to make sure that it doesn't cause you breakthrough bleeding before your vacation starts.
I can sense that you are truly looking for some sort of medical guarantee that you will not bleed during your holiday. This is impossible for any health provider to be able to guarantee. However, I do disagree with the opinions of the physicians who suggested taking additional progesterone to prevent bleeding and staying on your current pill.
I am a board-certified US trained OB/GYN physician who is been practicing in United States for almost 20 years. I hope that that may provide some additional credibility for my opinion and hopefully to provide you with some reassurance.
I wish you the best of luck in your decision about how to proceed, and I hope your vacation works out for the best and you do not have any breakthrough bleeding.
Dr. Brown
I do not agree with taking extra progesterone to prevent breakthrough bleed
Detailed Answer:
Norethisterone is simply a synthetic form of the hormone progesterone, in a tablet. There are 35 µg pills such as Necon 1/35 that contain 35 µg of estrogen and the US equivalent of Norethisterone. This pill is also well tolerated by patients and would be a good choice for continuous cycling.
Progesterone, like norethisterone, when given to a normally menstruating woman who is not on birth control, will delay your cycle because progesterone is the hormone primarily responsible for stabilizing the uterine lining after ovulation. For this purpose, it works very well. But if you are on birth control, adding extra progesterone will not necessarily help prevent breakthrough bleeding. This makes sense if you understand that in a normal menstrual cycle, when you're not on the pill, your estrogen levels are much higher than when taking a low dose birth control pill. So then progesterone alone would stabilize your uterine lining that is been built up by all the estrogen of your normal cycle.
I would NOT recommend a 50 µg birth control pill because these are considered high-dose formulations and in reality no form of birth-control above 35 mg provides any additional help with breakthrough bleeding over the modern low (35 microgram) dose formulations. Furthermore, because of your obesity, I would not recommend taking this high dose of estrogen because of the risk of blood clotting.
As I stated previously I would recommend either changing back to Seasonale, which works for you before, or starting a monthly cycle pill such as Necon 1/35 which contains the US equivalent of norethisterone. Your body has about six weeks to adjust to a new pill formulation before your holiday. I do not recommend staying on your current pill as you already have breakthrough bleeding while taking it. It makes more sense to start on a new pill and try to make sure that it doesn't cause you breakthrough bleeding before your vacation starts.
I can sense that you are truly looking for some sort of medical guarantee that you will not bleed during your holiday. This is impossible for any health provider to be able to guarantee. However, I do disagree with the opinions of the physicians who suggested taking additional progesterone to prevent bleeding and staying on your current pill.
I am a board-certified US trained OB/GYN physician who is been practicing in United States for almost 20 years. I hope that that may provide some additional credibility for my opinion and hopefully to provide you with some reassurance.
I wish you the best of luck in your decision about how to proceed, and I hope your vacation works out for the best and you do not have any breakthrough bleeding.
Dr. Brown
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Ok im a little confused at the beginning you told me what progesterine was then said to switch to a higher level combo pill but then at the end said you agreed with the opinion to cintinue with my current pill and add 5mg progesterone for those 10 days like the others said. Im nit sure which you are recommending two of them told me to keep on with this one and just add the 5 mg progesterone for those 10 days and i wouldnt bleed. Do you agree ? What if i switxhes to a higher dose and id i has breathed bleeding at any time then whrn i go i add the 5 mg for the time im gone how would that work. Im confused
Brief Answer:
I do not agree with adding Progesterone (Primalout) to your current pill
Detailed Answer:
I apologize that my previous answer was not clear. I reviewed the answers of the physicians who posted advise to you previously. It seems that you misunderstood my answer-
I do NOT think you should continue your current pill because you currently have breakthrough bleeding. It does not make sense to continue a pill that already gives you a side effect you are trying to prevent.
I also do NOT believe that taking additional progesterone (Northisterone is one type of progesterone) along with ANY pill regimen will help prevent breakthrough bleeding because of the nature of hormone levels on the pill compared to taking it to delay your period when not on the pill at all (which does work)
I advised you to either change to Seasonale or a monthly cycle 35 microgram pill, and if your pill-free week is due to occur while you are in New Mexico, then just do not take the placebo pills and just start the next pack.
It is your choice for which to try because there is no conclusive medical evidence that either one will work better than the other.
I hope that clarifies my position better for you, and I am sorry that I disagree with the other physician who advised you. In XXXXXXX using Northisterone in this way is very common, however in the US it is not regarded as a successful treatment.
Best,
Dr. Brown
I do not agree with adding Progesterone (Primalout) to your current pill
Detailed Answer:
I apologize that my previous answer was not clear. I reviewed the answers of the physicians who posted advise to you previously. It seems that you misunderstood my answer-
I do NOT think you should continue your current pill because you currently have breakthrough bleeding. It does not make sense to continue a pill that already gives you a side effect you are trying to prevent.
I also do NOT believe that taking additional progesterone (Northisterone is one type of progesterone) along with ANY pill regimen will help prevent breakthrough bleeding because of the nature of hormone levels on the pill compared to taking it to delay your period when not on the pill at all (which does work)
I advised you to either change to Seasonale or a monthly cycle 35 microgram pill, and if your pill-free week is due to occur while you are in New Mexico, then just do not take the placebo pills and just start the next pack.
It is your choice for which to try because there is no conclusive medical evidence that either one will work better than the other.
I hope that clarifies my position better for you, and I am sorry that I disagree with the other physician who advised you. In XXXXXXX using Northisterone in this way is very common, however in the US it is not regarded as a successful treatment.
Best,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
is there any particular reason why there is such a difference? I mean it would seem to me, if something WORKS like they say it does in XXXXXXX it would be common standard throughout the world, but htat's just me :) ....so what would happen if I upped my dosage on my bc pill to say seasonale....and then on those days that I was with him took the extra progesterone...Not saying that's what im going to do because I think the seasonale alone will combat the breakthrough bleeding, but What woud happen if I did that?.....would there be anything drastic happen, or is it just Not necessary?.....
Brief Answer:
Please look at reviews and references below for additional information:
Detailed Answer:
I am not saying that the doctor in XXXXXXX was recommending a treatment that is not effective- it is just not effective on people already on birth control pills. I believe she may just be mistaken in her advice in your particular situation. Because many women have breakthrough bleeding on progesterone based contraceptives, and your goal is cycle control, I recommend that you do not take the extra progesterone as it may actually worsen the breakthrough bleeding.
Here is a reference for you to review:
http://yyyyyy.info/health/yyyyyyyy-a-yyyyyyy
Here is another from the UK:
https://yyyyyyyyy.yyyyyyyyyyyy.com/uk/info/how-can-i-delay-my-period
And a good overall summary of my recommendations:
http://www.yyyyyy.yyyy/afp/2002/0515/p2073.html
Because I have never prescribed extra progesterone to someone on the pill to combat breakthrough bleeding, I cannot comment on whether or not taking the extra progesterone will cause any undesirable side effects. However, I hope the medical references I provided may help you understand why I believe taking a birth control pill with higher estrogen levels alone will solve your problem. I have attempted to find any medical reference on successfully using progesterone to delay menses while on oral contraceptives and have been unable to find any.
I hope this helps you in making your decision.
Sincerely,
Dr. Brown
Please look at reviews and references below for additional information:
Detailed Answer:
I am not saying that the doctor in XXXXXXX was recommending a treatment that is not effective- it is just not effective on people already on birth control pills. I believe she may just be mistaken in her advice in your particular situation. Because many women have breakthrough bleeding on progesterone based contraceptives, and your goal is cycle control, I recommend that you do not take the extra progesterone as it may actually worsen the breakthrough bleeding.
Here is a reference for you to review:
http://yyyyyy.info/health/yyyyyyyy-a-yyyyyyy
Here is another from the UK:
https://yyyyyyyyy.yyyyyyyyyyyy.com/uk/info/how-can-i-delay-my-period
And a good overall summary of my recommendations:
http://www.yyyyyy.yyyy/afp/2002/0515/p2073.html
Because I have never prescribed extra progesterone to someone on the pill to combat breakthrough bleeding, I cannot comment on whether or not taking the extra progesterone will cause any undesirable side effects. However, I hope the medical references I provided may help you understand why I believe taking a birth control pill with higher estrogen levels alone will solve your problem. I have attempted to find any medical reference on successfully using progesterone to delay menses while on oral contraceptives and have been unable to find any.
I hope this helps you in making your decision.
Sincerely,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Raju A.T
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